Evidence map›Paper›PMID 40721813›Full record

ArticleTrials2025

The articulated laparoscopic total mesorectal excision for rectal cancer (ATOME trial): a single-arm, prospective trial with pre-specified comparison to robotic surgery.

Kyeong Eui Kim, Sung Uk Bae, Seung Hyun Lee, Dae-Ro Lim, Heon-Kyun Ha, Jin Kim, Hyo Seon Ryu, Soo Yeon Park, Sung Il Kang, Gyung Mo Son and 14 more

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Kyeong Eui KimDepartment of Surgery, School of Medicine, Keimyung University and Dongsan Medical Center, Daegu, South Korea.
Sung Uk BaeDepartment of Surgery, School of Medicine, Keimyung University and Dongsan Medical Center, Daegu, South Korea. sabiston0000@hanmail.net.
Seung Hyun LeeDepartment of Surgery, Kosin University College of Medicine, Busan, South Korea.
Dae-Ro LimDivision of Colon and Rectal Surgery, Department of Surgery, Soonchunhyung University College of Medicine, Soonchunhyung Univerisity Bucheon Hospital, Bucheon, South Korea.
Heon-Kyun HaDepartment of Surgery, Chung-Ang University Hospital, Seoul, South Korea.
Jin KimDepartment of Surgery, Korea University College of Medicine, Seoul, South Korea.
Hyo Seon RyuDepartment of Surgery, Korea University College of Medicine, Seoul, South Korea.
Soo Yeon ParkColorectal Cancer Center, School of Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University, Daegu, South Korea.
Sung Il KangDepartment of Surgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, South Korea.
Gyung Mo SonDepartment of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea.
Soo Young LeeDepartment of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, South Korea.
Chang Hyun KimDepartment of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, South Korea.
Kyung Ha LeeDepartment of Surgery, Chungnam National University College of Medicine, Deajeon, South Korea.
Gi Won HaResearch Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk, South Korea.
Hye Jin KimColorectal Cancer Center, School of Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University, Daegu, South Korea.
Woong Bae JiDivision of Colon and Rectal Surgery, Korea University Ansan Hospital, Ansan, Gyeonggi-Do, South Korea.
Woo Ram KimDivision of Colorectal Surgery, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Sang Hee KangDepartment of Surgery, Korea University College of Medicine, Seoul, South Korea.
Nak Song SungDepartment of Surgery, Konyang University Hospital, Daejeon, South Korea.
Ji Hoon KimDivision of Colorectal Surgery, Department of Surgery, Incheon St. Mary's Hospital, the Catholic University of Korea, Incheon, South Korea.
Taek-Gu LeeDepartment of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju-Si, Chungcheongbuk-Do, 28644, South Korea.
Myung Jo KimDepartment of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju-Si, Chungcheongbuk-Do, 28644, South Korea.
Woon Kyung JeongDepartment of Surgery, School of Medicine, Keimyung University and Dongsan Medical Center, Daegu, South Korea.
Seong Kyu BaekDepartment of Surgery, School of Medicine, Keimyung University and Dongsan Medical Center, Daegu, South Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLaparoscopic total mesorectal excision (TME) has become the standard surgical treatment for rectal cancers, despite being a technically challenging procedure due to the straight and rigid nature of the laparoscopic instrument within a narrow bony pelvis. A robotic system with multi-joint instruments, three-dimensional vision, and improved ergonomics was introduced, however it is not yet cost-effective. Recently, several articulating laparoscopic instruments have been developed and introduced as substitutes for multi-joint robotic system instruments. The prospective study aims to demonstrate that the positive rate of circumferential resection margin following laparoscopic surgery with articulated laparoscopic instruments is non-inferior to that of robotic surgery in the treatment of rectal cancer. METHODS/

designPatients with primary rectal cancer who are treated with low anterior resection using articulated laparoscopic instruments will be included in the study. Participating colorectal surgeons must use articulated laparoscopic instruments at least during TME. We hypothesize that the positive rate of circumferential resection margin after robotic surgery will be 6%, 3 based on the previous studies. A trial with 157 patients contributing to the primary outcome analysis would have 80% power to declare non-inferiority with a 5.2% non-inferiority margin, assuming a 10% dropout rate. To compare laparoscopic TME group and robotic TME group, we adjust for variables such as gender, T stage, N stage, sphincter saving status, and preoperative chemoradiation using propensity score matching. The primary end-point of this study is cicumferential resection margin after surgery. DISCUSSION: Based on this study, we hope to demonstrate the efficacy and viability of articulated laparoscopic instruments in the treatment of rectal cancer at a lower cost than robotic surgery.

trial registrationClinical Research Information Service KCT0008896. Registered on 15 August 2023.

Indexed as

LaparoscopyProctectomyRectal NeoplasmsRobotic Surgical ProceduresEquivalence Trials as TopicFemaleHumansMaleMargins of ExcisionProspective StudiesTreatment OutcomeColorectal surgeryLaparoscopyRectal neoplasmsSurgical instrumentsTreatment outcome

Identifiers

PMID40721813
PMCPMC12306080

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.